After a demonstration of isometric (muscle-setting) exercises, which of the following comments by the patient tells you he has understood how to do the exercises?

Correct Answer: B

Rationale: The correct answer is B) "I draw the kneecap toward the thigh, hold for 5 seconds and relax." This response demonstrates an understanding of isometric exercises, which involve contracting a muscle without changing its length. By describing the action of drawing the kneecap toward the thigh and holding for a specific duration, the patient shows comprehension of how to perform the exercise correctly. Option A is incorrect because it mentions pulling on a traction rope, which is not typically used in isometric exercises and does not reflect an understanding of the correct technique. Option C involves using a trapeze to lift oneself off the bed, which is not an isometric exercise but rather an activity requiring dynamic movement. Option D describes turning to the right side, which is unrelated to the task of isometric muscle-setting exercises. In an educational context, it is crucial for patients to understand and perform exercises correctly to benefit from their therapeutic effects. By providing clear instructions and ensuring patient comprehension, healthcare professionals can help patients engage in appropriate rehabilitation or strengthening activities to support their neurological health and recovery.

Correct Answer: A

Rationale: In a patient with periarteritis nodosa, it is most important to ask questions related to dysfunction of the cardiovascular system. Periarteritis nodosa is a systemic vasculitis that primarily affects medium-sized arteries, leading to inflammation and damage to blood vessels. This can result in serious cardiovascular complications such as hypertension, aneurysms, and organ ischemia. Option A, cardiovascular, is the correct choice because the disease directly impacts the blood vessels and heart, making it crucial to monitor and address any dysfunction in these areas. Option B, renal, may also be affected in periarteritis nodosa due to compromised blood flow to the kidneys, but the primary focus should be on the cardiovascular system due to the nature of the disease. Option C, visual, is less likely to be affected in periarteritis nodosa compared to the cardiovascular system. While eye involvement can occur in some cases, it is not the most critical system to monitor in this condition. Option D, immunologic, is important in understanding the underlying cause of periarteritis nodosa (an autoimmune reaction), but in terms of immediate health history assessment, cardiovascular dysfunction poses the most significant risk to the patient's well-being. Educationally, understanding the importance of focusing on specific systems in different diseases helps healthcare providers prioritize their assessments and interventions, leading to better patient outcomes. It also highlights the interconnectedness of bodily systems and how dysfunction in one area can impact others.

Correct Answer: B

Rationale: In this scenario, option B, which is palpating the muscles and joints, is the correct method to help a nurse identify swelling in a client who has experienced a musculoskeletal injury to her hip. Palpation involves using touch to feel for abnormalities such as swelling, tenderness, or warmth in the affected area. Swelling is often palpable due to the increase in fluid accumulation in the tissues surrounding the injury site. Option A, asking questions about pain severity, may provide information on the client's subjective experience but may not directly identify swelling. Option C, asking the client to move the injured area, could potentially exacerbate the injury or cause further damage if there is swelling present. Option D, observing for involuntary movements, is more relevant for assessing neurological issues rather than identifying swelling. In an educational context, it is crucial for nurses to understand the proper techniques for assessing musculoskeletal injuries to provide accurate care and treatment. Palpation is a fundamental skill that allows healthcare providers to gather important information about the client's condition, including identifying swelling, tenderness, or other abnormalities. By mastering palpation techniques, nurses can enhance their assessment skills and provide better care for clients with musculoskeletal injuries.

Correct Answer: A

Rationale: The correct answer is A) Withholding aspirin before the surgery. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits platelet function and can prolong bleeding time. By withholding aspirin before surgery, the risk of excessive bleeding during and after the orthopedic procedure is reduced. Option B) Withholding antacids before the surgery is not directly related to reducing the risk of excessive bleeding. Antacids primarily work on reducing stomach acid and do not significantly impact bleeding risks in orthopedic surgeries. Option C) Encouraging the intake of red meat before the surgery is not recommended as it does not have a direct impact on bleeding risk. Red meat consumption is not a factor in reducing bleeding complications in orthopedic surgeries. Option D) Avoiding excess fluid intake before the surgery is also not directly related to reducing the risk of excessive bleeding. Maintaining adequate hydration is important for overall health but does not specifically address the issue of bleeding risk during orthopedic procedures. In an educational context, it is crucial for healthcare providers to understand the effects of different medications and dietary factors on surgical outcomes. By selecting the appropriate preoperative interventions, such as withholding aspirin in this case, healthcare professionals can optimize patient safety and surgical outcomes. This question highlights the importance of medication management in the perioperative period to minimize potential complications during surgery.

Correct Answer: C

Rationale: In the context of a client with lupus erythematosus, the correct instruction before performing range of motion (ROM) exercises would be to use moist heat (Option C). The rationale behind this is that moist heat helps to increase blood flow, relax muscles, and reduce joint stiffness, making it an ideal preparatory measure for ROM exercises in this population. Prescribed analgesics (Option A) may help manage pain but do not directly facilitate the effectiveness of ROM exercises. Cold packs (Option B) are more commonly used for acute injuries or inflammation, which may not be the case in clients with lupus. Braces or splints (Option D) are typically used for joint support or stabilization and are not directly related to preparing for ROM exercises. Educationally, it is important for nurses to understand the specific needs of clients with lupus when recommending pre-exercise strategies. Providing rationale and evidence-based instructions ensures that clients receive the most appropriate care tailored to their condition, ultimately promoting better outcomes and adherence to therapeutic interventions.